Published in:
01-12-2018 | Fatty Liver Disease (Z Younossi, Section Editor)
The Impact of Metabolic Syndrome on the Outcome of NASH: Cirrhosis, Hepatocellular Carcinoma, and Mortality
Authors:
Ramy Younes, Elisabetta Bugianesi
Published in:
Current Hepatology Reports
|
Issue 4/2018
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Abstract
Purpose of Review
In this review, we examine the interaction between the metabolic syndrome (MS) and non-alcoholic fatty liver disease (NAFLD) and describe the impact of the features of MS on the most worrisome complications of non-alcoholic steatohepatitis (NASH), (cirrhosis, hepatocellular carcinoma) and, ultimately, on liver-related, cardiovascular, and overall mortality.
Recent Findings
Insulin resistance, obesity, and dyslipidemia in a pro-inflammatory environment have a causal role in hepatic fibrogenesis and oncogenesis in NAFLD patients. Natural history, longitudinal studies confirm the conditions linked to MS as independent predictors of overall-, cardiovascular-, and liver-related mortality.
Summary
Dysmetabolic factors stemming from insulin resistance play a key role in liver damage progression. Obesity, type 2 diabetes (T2DM), dyslipidemia, and arterial hypertension are independent predictors of liver fibrosis and cirrhosis; furthermore, obesity and T2DM play a key role in the development of hepatocellular carcinoma both in cirrhotic and non-cirrhotic NASH patients.